Posts tagged iron
Articles and news from the latest research reports.
MRI Technique May Help Prevent ADHD Misdiagnosis
Brain iron levels offer a potential biomarker in the diagnosis of attention deficit hyperactivity disorder (ADHD) and may help physicians and parents make better informed treatment decisions, according to new research published online in the journal Radiology.
ADHD is a common disorder in children and adolescents that can continue into adulthood. Symptoms include hyperactivity and difficulty staying focused, paying attention and controlling behavior. The American Psychiatric Association reports that ADHD affects 3 to 7 percent of school-age children.
Psychostimulant medications such as Ritalin are among the drugs commonly used to reduce ADHD symptoms. Psychostimulants affect levels of dopamine, a neurotransmitter in the brain associated with addiction.
"Much debate and concern has emerged regarding the continual rise of ADHD diagnosis in the U.S. given that two-thirds of those diagnosed receive psychostimulant medications," said Vitria Adisetiyo, Ph.D., postdoctoral research fellow at the Medical University of South Carolina in Charleston, S.C. "We wanted to see if we could identify brain iron as a potential noninvasive biomarker for medication-naïve ADHD to prevent misdiagnosis."
For the study, the research team measured brain iron levels in 22 children and adolescents with ADHD, 12 of whom had never been on medication for their condition (medication naïve), and 27 healthy control children and adolescents using a magnetic resonance imaging (MRI) technique called magnetic field correlation imaging. The technique was introduced in 2006 by study co-authors and faculty members Joseph A. Helpern, Ph.D., and Jens H. Jensen, Ph.D. No contrast agents were used, and blood iron levels in the body were measured using a blood draw.
The results showed that the 12 ADHD medication-naïve patients had significantly lower brain iron levels than the 10 ADHD patients who had been on psychostimulant medication and the 27 children and adolescents in the control group. In contrast, ADHD patients with a history of psychostimulant medication treatment had brain iron levels comparable to controls, suggesting that brain iron may increase to normal levels with psychostimulant treatment.
"Our research suggests that iron absorption into the brain may be abnormal in ADHD given that atypical brain iron levels are found even when blood iron levels in the body are normal," Dr. Adisetiyo said. "We found no differences in blood iron measures between controls, medication-naïve ADHD patients or pscyhostimulant-medicated ADHD patients."
Magnetic field correlation imaging’s ability to noninvasively detect the low iron levels may help improve ADHD diagnosis and guide optimal treatment. Currently, ADHD diagnosis is based only on subjective clinical interviews and questionnaires. Having a biological biomarker may help inform clinical diagnosis, particularly in borderline cases, Dr. Adisetiyo noted.
If the results can be replicated in larger studies, magnetic field correlation might have a future role in determining which patients would benefit from psychostimulants—an important consideration because the drugs can become addictive if taken inappropriately and lead to abuse of other drugs like cocaine.
"We want the public to know that progress is being made in identifying potential noninvasive biological biomarkers of ADHD which may help to prevent misdiagnosis," Dr. Adisetiyo said. "We are currently testing our findings in a larger cohort to confirm that measuring brain iron levels in ADHD is indeed a reliable and clinically feasible biomarker."
Uncovering the underlying causes of Parkinson’s disease
A breakthrough investigation by UTS researchers into the underlying causes of Parkinson’s disease has brought us a step closer to understanding how to manage the condition.
The team, led by UTS postdoctoral fellow Dr Dominic Hare and Professor Philip Doble, has produced the first empirical evidence that an imbalance of iron and dopamine in the substantia nigra pars compacta (SNc) region of the brain is the root cause of the neurodegenerative condition.
Caused by the slow loss of neurons in the SNc that control autonomous movement, Parkinson’s disease causes persistent shaking, gastrointestinal problems and a variety of other ailments.
More than 80,000 Australians suffer from the illness, most over the age of 60.
Hare’s findings, before only assumptions in the scientific community, finally validate the theory that iron and dopamine react to create free radicals in the brain that slowly destroy neuron pathways and bring about the onset of Parkinson’s.
"When these two chemicals react, it forms a toxic species of dopamine that essentially reacts like bleach in the brain," said Hare.
To conduct their research Hare and his team used a unique tagging technique using antibodies labelled with gold nanoparticles that acted as proxies for dopamine molecules. This enabled the team to monitor and “co-localise” metals with other molecules and proteins in the brain.
And the findings of this work, said Hare, were revelatory.
"What we found is those particular cells (in the SNc) have what you could call an ‘anti-Goldilocks effect’ – they have just the right amount of iron and just the right amount of dopamine to cause damage," said Dr Hare.
"When we give mice a toxin that mimics the effects of Parkinson’s disease, these cells degenerate."
Hare theorises that this effect is likely a natural result of aging, when the brain’s ability to securely store iron diminishes and allows iron molecules to “leak” into critical areas such as the SNc.
Finding ways to design drugs that can get into the brain and eliminate surplus iron – an initiative that is already well underway in the process of treating other illnesses like cancer and Alzheimer’s disease – is now the next step forward in research.
Preventative measures to halt the build-up of iron in the brain as humans undergo the aging process are also touted by Hare as an important next step, and is something he is now working on.
"I think the real hope is, while we might not necessarily find a cure, prevention is actually not that far away," said Hare.
"So it’s a case where you can wake up and say, ‘my Parkinson’s is flaring up again’, take a tablet and go about your business."
New imaging research shows increased iron in the brain in earliest stages of MS
While it’s been known for over a century that iron deposits in the brain play a role in the pathology of Multiple Sclerosis (MS), new imaging research from Western University (London, Canada) helps to answer the question of whether these accumulations are a cause or consequence of the disease. The study led by Ravi Menon, PhD, of the Robarts Research Institute found iron deposits in deep gray matter, suggesting the accumulation occurs very early in the disease course. The researchers also found evidence casting further doubt on the controversial liberation therapy for MS. The research is in early publication online in Multiple Sclerosis and Related Disorders.
Menon and PhD candidate Matthew Quinn used 3-Tesla Magnetic Resonance Imaging (MRI) to scan 22 patients with clinically isolated syndrome (CIS). These are patients who’ve had a single clinical attack, at least half of whom will go on to be diagnosed with MS. The others may have a different disease. Sixteen age and sex matched controls were also studied.
"We wanted to know if the iron deposits happen early in the process, or whether it’s something that accumulates with time as the disease progresses," says Menon, who holds a Canada Research Chair in Functional Magnetic Imaging. "We also studied the veins that drain from the brain and looked for a correlation between the diameter of of these veins and iron accumulation. One of the reasons to do this, of course was the hypothesis proposed by Paolo Zamboni that if you had narrow jugular veins, this would give rise to additional iron and in turn cause MS."
The scientists found iron deposits in the CIS group were well above the amounts found in the control group. The MRIs also revealed for the first time, subtle damage to the brain’s white matter even at this early stage. The researchers also found no correlation between the iron deposits and diameter of the veins.
"So while the iron in the brain correlates with the disability of the subjects, the iron in the brain does not correlate with the actual diameter of the jugular veins. So the Zamboni hypothesis is incorrect as far as the iron being related to some kind of obstruction." Menon found narrowed veins in the control group as well as the CIS group, and both groups had narrower veins on one side compared to the other.
Menon hopes this imaging research will lead to the earlier diagnosis of MS. He plans to follow the patients every four months for the next two years, to see retrospectively, what characterizes those patients that go on to be diagnosed with MS compared to those who do not.
"We’re looking at a couple of different approaches to diagnostics using this imaging research. In suspected MS cases –the very first time they appear in clinic, if they have an abnormally high amount of iron in the frontal cortex of the brain –that’s probably a pretty good sign they have MS or some other white matter disease." This research was funded primarily by the Canadian Institutes of Health Research.
MS is the most common neurological disease affecting young adults, with symptoms that include loss of balance, impaired speech, double vision, extreme fatigue and paralysis.
Normal prion protein regulates iron metabolism
An iron imbalance caused by prion proteins collecting in the brain is a likely cause of cell death in Creutzfeldt-Jakob disease (CJD), researchers at Case Western Reserve University School of Medicine have found.
The breakthrough follows discoveries that certain proteins found in the brains of Alzheimer’s and Parkinson’s patients also regulate iron. The results suggest that neurotoxicity by the form of iron, called redox-active iron, may be a trait of neurodegenerative conditions in all three diseases, the researchers say.
Further, the role of the normal prion protein known as PrPc in iron metabolism may provide a target for strategies to maintain iron balance and reduce iron-induced neurotoxicity in patients suffering from CJD, a rare degenerative disease for which no cure yet exists.
The researchers report that lack of PrPC hampers iron uptake and storage and more findings are now in the online edition of the Journal of Alzheimer’s Disease.
"There are many skeptics who think iron is a bystander or end-product of neuronal death and has no role to play in neurodegenerative conditions," said Neena Singh, a professor of pathology and neurology at Case Western Reserve and the paper’s senior author. "We’re not saying that iron imbalance is the only cause, but failure to maintain stable levels of iron in the brain appears to contribute significantly to neuronal death."
Prions are misfolded forms of PrPC that are infectious and disease-causing agents of CJD. PrPc is the normal form present in all tissues including the brain. PrPc acts as a ferrireductase, that is, it helps to convert oxidized iron to a form that can be taken up and utilized by the cells, the scientists show.
In their investigation, mouse models that lacked PrPC were iron-deficient. By supplementing their diets with excess inorganic iron, normal levels of iron in the body were restored. When the supplements stopped, the mice returned to being iron-deficient.
Examination of iron metabolism pathways showed that the lack of PrPC impaired iron uptake and storage, and alternate mechanisms of iron uptake failed to compensate for the deficiency.
Cells have a tight regulatory system for iron uptake, storage and release. PrPC is an essential element in this process, and its aggregation in CJD possibly results in an environment of iron imbalance that is damaging to neuronal cells, Singh explained
It is likely that as CJD progresses and PrPC forms insoluble aggregates, loss of ferrireductase function combined with sequestration of iron in prion aggregates leads to insufficiency of iron in diseased brains, creating a potentially toxic environment, as reported earlier by this group and featured in Nature Journal club.
Recently, members of the Singh research team also helped to identify a highly accurate test to confirm the presence of CJD in living sufferers. They found that iron imbalance in the brain is reflected as a specific change in the levels of iron-management proteins other than PrPc in the cerebrospinal fluid. The fluid can be tapped to diagnose the disease with 88.9 percent accuracy, the researchers reported in the journal Antioxidants & Redox Signaling online last month.
Singh’ s team is now investigating how prion protein functions to convert oxidized iron to a usable form. They are also evaluating the role of prion protein in brain iron metabolism, and whether the iron imbalance observed in cases of CJD, Alzheimer’s disease and Parkinson’s disease is reflected in the cerebrospinal fluid. A specific change in the fluid could provide a disease-specific diagnostic test for these disorders.
(Source: eurekalert.org)